Mobility Aids Overview & Comparison

About 93% of people living in residential aged care facilities and half of Australians living with disabilities use mobility aids (ABS 2015).

As a healthcare worker, you are likely to interact with clients using mobility aids. Do you know how to appropriately care for these people and ensure they stay safe?

What are Mobility Aids?

Mobility aids help to improve the functional capacity of people who have difficulty ambulating through one or more of the following:

Improving balance;
Improving walking pattern;
Increasing propulsion;
Reducing the load on lower limbs;
Transmitting sensory cues through the hands;
Facilitating upright posture;
Allowing the client to access to a variety of environments;
Signalling to other people that the person requires special considerations; and
Improving overall safety during independent mobilisation.

(Musculoskeletal Key 2017; Physiopedia n.d.)

Benefits of Mobility Aids

Greater independence;
Ability to go about daily life;
Ability to participate in the community;
Greater quality of life;
Increased confidence and self-esteem;
Reduced pain and fatigue;
Social inclusion;
Improved end of life care;
Reduced falls risk;
Reduced risk of hospitalisation; and
Shorter hospital stays.

(Better Health Channel 2019; Musculoskeletal Key 2017; CECOPS 2020; Leonard 2017; SA DoH 2019)

Who Uses Mobility Aids?

Mobility aids can be helpful for any person with a mobility issue. This includes, but is not limited to:

People with:
- Arthritis;
- Cerebral palsy;
- Diabetic ulcers or wounds;
- Balance difficulties;
- Fractures of broken bones;
- Gout;
- Heart or lung issues;
- Leg, foot or back injuries;
- Sprains or strains;
- Brain injury or stroke;
- Visual impairment or blindness;
Older adults;
People who have had an amputation;
People who are recovering from surgery;
People with a high falls risk.

(Leonard 2017)

Types of Mobility Aids

Mobility aids come in a variety of sizes and styles. The person’s abilities, needs, environment and body shape should always be taken into consideration (SA DoH 2019).

Larger mobility aids are usually more stable but may decrease walking speed and make it more difficult to access certain environments (CEC 2016a).

Generally, a physiotherapist or occupational therapist is responsible for prescribing a mobility aid (CEC 2016a). This will be based on an assessment of several factors, including:

Gait;
Balance;
Cognition;
Physiological systems (cardiovascular, musculoskeletal and neurological);
Comorbidities;
Daily mobility requirements; and
Whether the mobility aid is required short term or long term.

(Physiopedia n.d.)

The following table lists some of the mobility aids you might encounter when caring for clients:

Crutches, Walking Sticks and Walking Frames

Mobility Aid	Commonly Used for	Benefits	Limitations
Underarm crutches	Acute, short term injuries where the client can only put weight on one leg	Height adjustable Improve stability Widen base of support, reducing falls risk Help to off-load body weight	Cause the client to lean forward, possibly affecting posture Require good shoulder, arm and hand function
Forearm/elbow crutches	Long term support for clients who can put weight on both legs
Walking sticks/canes Single-point Three-point (Tripod) Four-point (Quad stick)	Providing basic support Assisting with balance Decreasing weight on one leg	Range of handle shapes and materials available Widen base of support (tripods and quad sticks) Portable and lightweight	Tripods and quad sticks may be a tripping hazard Quad sticks may slow walking Only support one side of the body Can increase falls risk if used incorrectly
Three and four-wheeled walking frames	People who can walk well but require extra support for long distances	Improve stability Widen base of support, reducing falls risk Foldable and portable Height adjustable	Cause the client to lean forward, possibly affecting posture Require good function of both arms
Two-wheeled walking frames (Rollator frames)	People who can stand with light support but require extra support for walking People with reduced weight bearing on one leg and require more support than crutches Best for indoor or short-distance use
Static walking frames	People who require support for standing and walking
Forearm support frames	When maximum weight support is required (e.g. following hip or pelvic fracture) Clients who are not able to take weight through the wrists or hands	Height adjustable	Lack maneuverability due to larger size

(SA DoH 2019; National MS Society 2013; CEC 2016a, c)

Correctly Fitting Crutches, Walking Sticks and Walking Frames

Underarm Crutches

The top axilla pad should be 5 cm under the armpit.
The base of the crutch should be 15 cm from the foot.
The client's elbows should be at a 15-30 degree bend.
The handgrip should be at the height of the wrist crease.

Forearm/elbow Crutches

The client's elbows should be at a 15-30 degree bend.
The handgrip should be at the height of the wrist crease.
The forearm cuff height should be set by measuring from a clenched fist to 2.5 cm below the elbow crease.

Walking sticks/canes

The client should stand upright with shoulders relaxed and arms by their sides.
The client's elbows should be at a 15-30 degree bend.
The handle should be at the height of the wrist crease.
The base of the stick should be 15 cm from the foot.

Walking frames (Three and four-wheeled, two-wheeled and static)

The client should stand upright with shoulders relaxed and arms by their sides.
The client's elbows should be at a 15-30 degree bend.
The handle should be at the height of the wrist crease.

Forearm support frames

The client's shoulders should bew relaxed.
There should be a 90 degree bend at elbow.
The gutters of the frame should rest under the forearm.

(SA DoH 2019; CEC 2016a, c)

Note: Fitting measurements may vary depending on your organisation. Always refer to your organisation's policies and procedures.

Wheelchairs and Scooters

Mobility Aid	Commonly Used for	Benefits	Limitations
Manual wheelchair	People who are unable to walk functional distances independently, safely or efficiently	Enhances mobility Decreases falls risk Can be transported in vehicles	Can be tiring to operate May be difficult to propel over certain surfaces Requires wide and accessible spaces
Pushrim-activated power-assist wheelchair (PAPAW)	People who have difficulty propelling a manual wheelchair	Easier to propel over difficult surfaces Conserves energy Allows long-distance mobility with less physical effort Faster than a manual wheelchair	Heavy Difficult to lift and stow More difficult to propel if the system is turned off or the battery is not adequately charged Wider than a manual wheelchair
Power wheelchair	People who have difficulty propelling a manual wheelchair	Easier to propel over difficult surfaces Conserves energy Allows long-distance mobility with less physical effort Easier to manoeuvre indoors than a scooter	Heavy Can not usually be disassembled Requires maintenance and repairs Requires wide and accessible spaces
Motorised scooter	People who have difficulty walking but can sit down and stand up from a chair safely and independently	Conserves energy Allows long-distance mobility with less physical effort Can usually be disassembled for stowing	Can be difficult to manoeuvre due to length Requires good balance Can be unstable during turns Requires wide and accessible spaces

(National MS Society 2013)

Caring for Clients who use Mobility Aids

The following are some practical tips for ensuring clients who use mobility aids are able to ambulate safely and effectively:

Check client notes for any instructions about mobilisation.
Ensure you know the client’s capacity (i.e. whether they can get out of bed on their own, how far they are able to walk, whether they need assistance).
Always ensure the height and size of the aid are correctly adjusted to suit the client.
Ensure any tripping hazards such as mats and power cords are cleared from walkways. There should be enough unobstructed space for the client to move around safely using their mobility aid.
Ensure the client’s bed is a suitable height and the brakes are on.
Ensure the client’s mobility aid is able to fit through walkways.
Look out for wet or uneven flooring.
Ensure the lockable brakes on the mobility aid are engaged properly.
Check brakes, wheels and rubber tips regularly for damage (protruding or missing screws, split or loose hand grips, worn rubber tips etc.).
Consider the weight and size of the mobility aid when transporting the client.
Ensure the client’s footwear is well-fitting, flat and non-slip.
Ensure the client never uses the mobility aid to pull themselves into a standing position.
Consider administering pain relief (if required) around the time of mobilisation.
Refer the client to a physiotherapist if required.

(SA DoH 2019; CEC 2016b, 2017)

Conclusion

In order to ensure the clients in your care are able to ambulate safely, it is important that you understand and are familiar with the various mobility aids they might be using. This will help you to better understand their needs, are able to support them in a range of daily activities and tasks, and can appropriately address any hazards or problems they might encounter while using their mobility aid.

Additional Resources

References

Australian Bureau of Statistics 2015, Use of Aids and Equipment by People With Disability in Australia, ABS, viewed 9 September 2020, https://www.abs.gov.au/ausstats/abs@.nsf/Previousproducts/4430.0Main%20Features952015?opendocument&tabname=Summary&prodno=4430.0&issue=2015&num=&view=
Better Health Channel 2019, Aids and Equipment at Home, Better Health Channel, viewed 9 September 2020, https://www.betterhealth.vic.gov.au/health/servicesandsupport/aids-and-equipment-at-home
CECOPS 2020, Benefits of Disability Equipment, CECOPS, viewed 9 September 2020, http://www.cecops.org.uk/about-community-equipment/benefits-of-community-equipment/
Clinical Excellence Commission 2016b, Falls Prevention – Equipment Installation & Safe Use: Walking Frames, NSW DoH, viewed 9 September 2020, http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0008/327734/Walking-Frames-Equipment-Installation-and-safe-use_July-2016.pdf
Clinical Excellence Commission 2016c, Falls Prevention – Safe Use of Mobility Aids – Forearm Support Frame (May 2016), online video, 17 June, viewed 10 September 2020, https://www.youtube.com/watch?v=ZV01-lwNwng&feature=emb_title
Clinical Excellence Commission 2016a, Falls Prevention – Safe Use of Mobility Aids – Pickup and Rollator Frames (May 2016), online video, 17 June, viewed 10 September 2020, https://www.youtube.com/watch?time_continue=37&v=uYL2lzRWxY0&feature=emb_title
Clinical Excellence Commission 2017, Pointers for Safe Mobilisation - Give it a Go!, NSW DoH, viewed 10 September 2020, http://cec.health.nsw.gov.au/__data/assets/pdf_file/0009/399690/Pointers-For-Safe-Mobilisation-Give-It-A-Go!.pdf
Leonard 2017, What Types of Mobility Aids are Available?, Medical News Today, viewed 9 September 2020, https://www.medicalnewstoday.com/articles/318463
Musculoskeletal Key 2017, Assistive Devices for Ambulation, Musculoskeletal Key, viewed 9 September 2020, https://musculoskeletalkey.com/assistive-devices-for-ambulation/
National Multiple Sclerosis Society 2013, How to Choose the Mobility Device that is Right for You, National MS Society, viewed 9 September 2020, https://www.nationalmssociety.org/nationalmssociety/media/msnationalfiles/brochures/brochure-how-to-choose-the-mobility-device-that-is-right-for-you.pdf
Physiopedia n.d, Walking Aids, Physiopedia, viewed 9 September 2020, https://www.physio-pedia.com/Walking_Aids
South Australia Department of Health 2019, Walking Aids: Using and Measuring, SA DoH, viewed 9 September 2020, https://www.sa.gov.au/__data/assets/pdf_file/0020/19019/walking-aids-using-and-measuring.pdf

Test Your Knowledge

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Question 1 of 3

Generally, who requires underarm crutches?

People who can put weight on both legs and require long-term support.

People who can only put weight on one leg due to short term injury.

People who are unable to walk functional distances independently, safely or efficiently.

People who can walk well but require extra support for long distances.

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Understanding Mobility Aids